Evaluation of the regenerative potential of dentin conditioning and naturally derived scaffold for necrotic immature permanent teeth in a dog model

Int J Exp Pathol. 2020 Dec;101(6):264-276. doi: 10.1111/iep.12372. Epub 2020 Sep 28.

Abstract

This study evaluated the outcome of partial exposure of dentin matrix to ethylenediaminetetraacetic acid (EDTA) and application of platelet-rich fibrin (PRF) scaffold on regeneration of necrotic immature permanent teeth in a dog model. The present study was carried out on 216 permanent immature roots in nine mongrel dogs aged 6-9 months. Pulp necrosis and periapical pathosis were induced in 180 roots. These roots were divided into five equal groups (36 roots each) according to the treatment protocol: group I: blood clot; group II: 17% EDTA solution and blood clot; group III: PRF; group IV: 17% EDTA solution and PRF; and group V: without treatment (positive control). The negative control group (group VI) represented 36 untouched normal roots for normal maturation. The groups were followed up for 1, 2 and 3 months (subgroups). Maturation of the roots was monitored by radiography and histopathology. All data were statistically analysed. Group IV exhibited the highest increase in root length and thickness, decrease in apical diameter, the highest score of vital tissue infiltration and least inflammatory scores. There was a significant difference regarding the increase in root length and thickness and decrease in apical diameter in all subgroups of the experimental and negative control groups (P ≤ .05). PRF has a better regenerative potential than the blood clot during treatment of immature permanent teeth with necrotic pulp. Inclusion of 17% EDTA solution as a final irrigation enhances the regenerative potential of both PRF and blood clot.

Keywords: odontoblasts; periapical pathosis; pulp tissue; regenerative endodontics; revascularization; root maturation.

MeSH terms

  • Animals
  • Dental Pulp / physiology
  • Dental Pulp Necrosis
  • Dentin / physiology*
  • Disease Models, Animal
  • Dogs
  • Edetic Acid / pharmacology*
  • Female
  • Humans
  • Male
  • Odontoblasts / physiology
  • Platelet-Rich Fibrin / physiology
  • Regeneration
  • Tissue Engineering
  • Tissue Scaffolds*
  • Tooth Root / physiology

Substances

  • Edetic Acid